8 Translation 175
■■ Specification of a detailed timeline, assignment of team members to tasks,
an evaluation process, and a plan for how results will be reported
■■ Solicitation of feedback on the action plan from organizational leader-
ship, bedside clinicians, and other stakeholders
The action plan begins with an organizational assessment to evaluate the readi-
ness of the organization or the context for change. Organizational infrastructure
is the cornerstone of successful translation (Newhouse, 2010b). Infrastructure
provides human and material resources that are fundamental in preparation for
change (Greenhalgh et al., 2005; Newhouse, 2007a). Organizational readiness
is leveraged by assessing the current state and strategically planning for building
the capacity of the organization before implementation can begin.
Beyond human and material readiness, teams also need to consider organiza-
tional culture. Organizational culture refers to group-learned assumptions as the
organization integrates and adapts to external forces. These assumptions become
an attribute of the group and are then taught as the right way to “perceive, think,
and feel in relation to problems” (Schein, 2004, p. 17). To change the culture, the
team must challenge tradition, reinforce the need for evidence to drive decisions,
and change old patterns of behavior, which sometimes requires new skills in evi-
dence review. Additional detail and tools to assess organizational readiness and
culture are available elsewhere (Newhouse, 2010a).
Ensure Successful Action Planning
To ensure a successful translation (see Appendix A), first appoint a project leader
and identify change champions who are supportive of the recommended practice
change and who will be able to support the project leader during the translation
phase of the project. Once this leader is identified and change champions are
on board, consider whether the translation activities will require any additional
skills, knowledge, or particular individuals who can assist with or will be essen-
tial to the success of the work. These additional members, often referred to as
opinion leaders, are usually well-known individuals to the practice group in the
organization who are held in high esteem and could influence the practice group’s
